CMS Formulary

Displaying 26121-26130 of 1611142 results.
ID: 26121
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 762875
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26122
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 762849
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26123
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 762852
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26124
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 762859
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26125
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 762868
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26126
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 762897
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26127
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1009341
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 25
ID: 26128
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1595462
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26129
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1595473
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 26130
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1595478
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0